{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:24:26Z","timestamp":1790364266407,"version":"4.1.0"},"reference-count":24,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T00:00:00Z","timestamp":1591228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"funder":[{"name":"Allergiestiftung Ulrich M\u00fcller-Gierok"},{"name":"Lungeliga St. Gallen"},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["32003B_162820"],"award-info":[{"award-number":["32003B_162820"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2020,5,26]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Diagnosing asthma in children remains a challenge because respiratory symptoms are not specific and vary over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>In a real-life observational study, we assessed the diagnostic accuracy of respiratory symptoms, objective tests and two paediatric diagnostic algorithms (proposed by the Global Initiative for Asthma (GINA) and the National Institute for Health and Care Excellence (NICE)) in the diagnosis of asthma in school-aged children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied children aged 5\u201317\u2005years who were referred consecutively to pulmonary outpatient clinics for evaluation of suspected asthma. Symptoms were assessed by parental questionnaire. The investigations included specific IgE measurement or skin prick tests, measurement of exhaled nitric oxide fraction (<jats:italic>F<\/jats:italic><jats:sub>eNO<\/jats:sub>), spirometry, body plethysmography and bronchodilator reversibility (BDR). Asthma was diagnosed by paediatric pulmonologists based on all available data. We assessed diagnostic accuracy of symptoms, tests and diagnostic algorithms by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the curve (AUC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 514 participants, 357 (70%) were diagnosed with asthma. The combined sensitivity and specificity was highest for any wheeze (sensitivity=75%, specificity=65%), dyspnoea (sensitivity=56%, specificity=76%) and wheeze triggered by colds (sensitivity=58%, specificity=78%) or by exercise (sensitivity=55%, specificity=74%). Of the diagnostic tests, the AUC was highest for specific total airway resistance (sR<jats:sub>tot<\/jats:sub>; AUC=0.73) and lowest for the residual volume (RV)\/total lung capacity (TLC) ratio (AUC=0.56). The NICE algorithm had sensitivity=69% and specificity=67%, whereas the GINA algorithm had sensitivity=42% and specificity=90%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study confirms the limited usefulness of single tests and existing algorithms for the diagnosis of asthma. It highlights the need for new and more appropriate evidence-based guidance.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.00132-2020","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T18:26:55Z","timestamp":1591295215000},"page":"2000132","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":33,"title":["Diagnosis of asthma in children: findings from the Swiss Paediatric Airway Cohort"],"prefix":"10.1183","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3051-4542","authenticated-orcid":false,"given":"Carmen C.M.","family":"de Jong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva S.L.","family":"Pedersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5237-8668","authenticated-orcid":false,"given":"Rebeca","family":"Mozun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"M\u00fcller-Suter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Jochmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3471-5664","authenticated-orcid":false,"given":"Florian","family":"Singer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Casaulta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Regamey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7284-4251","authenticated-orcid":false,"given":"Alexander","family":"Moeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7924-518X","authenticated-orcid":false,"given":"Cristina","family":"Ardura-Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8957-2002","authenticated-orcid":false,"given":"Claudia E.","family":"Kuehni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,6,4]]},"reference":[{"key":"2024102101451095000_56.5.2000132.1","unstructured":"Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention, 2019. Available from: https:\/\/ginasthma.org\/wp-content\/uploads\/2019\/06\/GINA-2019-main-report-June-2019-wms.pdf Date last accessed: August 07, 2019."},{"key":"2024102101451095000_56.5.2000132.2","unstructured":"British Thoracic Society (BTS), Scottish Intercollegiate Guidelines Network (SIGN). British guideline on the management of asthma: a national clinical guideline. www.sign.ac.uk\/media\/1048\/sign158.pdf Date last updated: July 2019. Date last accessed: August 07, 2019."},{"key":"2024102101451095000_56.5.2000132.3","unstructured":"National Institute for Health and Care Excellence (NICE). Asthma: diagnosis, monitoring and chronic asthma management (guideline NG80) . www.nice.org.uk\/guidance\/ng80\/resources\/asthma-diagnosis-monitoring-and-chronic-asthma-management-pdf-1837687975621 Date last updated: February 12, 2020. 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